Healthcare Provider Details

I. General information

NPI: 1750799169
Provider Name (Legal Business Name): CRISBEL SUAREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2014
Last Update Date: 10/31/2022
Certification Date: 10/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17570 ATLANTIC BLVD APT 414
SUNNY ISLES BEACH FL
33160-2838
US

IV. Provider business mailing address

17570 ATLANTIC BLVD APT 414
SUNNY ISLES BEACH FL
33160-2838
US

V. Phone/Fax

Practice location:
  • Phone: 305-504-1749
  • Fax:
Mailing address:
  • Phone: 305-504-1749
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-21-56912
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: